Bilateral neovascular age-related macular degeneration: unilateral regression following endophthalmitis with persistent activity in the fellow eye

• Published in: BMJ case reports 2022-03, Vol.15 (3), p.e244771
• Main Authors: Gaur, Sandhya, Singh, Deependra Vikram, Reddy, Raja Rami, Sharma, Ajay
• Format: Article
• Language: English
• Subjects: Antibiotics; Case reports; Child, Preschool; Choroid - blood supply; Choroidal Neovascularization - complications; Choroidal Neovascularization - drug therapy; Endophthalmitis - complications; Endophthalmitis - drug therapy; Female; Follow-Up Studies; Humans; Macular degeneration; Macular Degeneration - complications; Macular Degeneration - drug therapy; Pathogenesis; Steroids; Tomography; Vascular endothelial growth factor
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2021-244771

A woman in her 70s who was being followed up for neovascular age-related macular degeneration (nAMD) in both eyes for 2 years with recalcitrant choroidal neovascularisation (CNV) and had an episode of acute endophthalmitis in one eye was identified. After treatment of postinjection culture-negative right eye (RE) endophthalmitis with intravitreal vancomycin and tazobactam, the patient had complete regression of treatment-resistant CNV in RE to date with postinfection follow-up of 2 years. In contrast, the fellow eye continued showing activity in the choroidal neovascular membrane that required antivascular endothelial growth factor injections on a pro re nata basis to date. Prolonged regression of nAMD for 3 years in the affected eye and continued activity in the fellow eye support the hypothesis that inflammation accompanying endophthalmitis or the drugs used for the treatment can have a role in the regression of nAMD.